The Global Fund needs global collaboration

The Global Fund to fight AIDS, TB, and malaria (TGF) was created in 2002 to stop the deaths and destructions caused by the three diseases.  Over $30 billion have been invested so far.  The Global Fund is asking for $15 billion for next three years, of which U.S. is asked to contribute $5 billion. So far, UK, France, Japan, Germany, Scandinavian countries, and Gates Foundation have made major commitments and increased their contributions.

Any fund spent to save millions of lives is a good investment.  The Global Fund, which receives major financial support from the U.S. and is led by a highly respected American health manager, is helping to reverse the course of these epidemics. HIV incidence has fallen by one-third, the cost of HIV drugs has dropped more than 99 percent. Malaria deaths have fallen by one-third, and TB deaths by 35 percent.  Global Fund investment saved 9 million lives worldwide.  Other international agencies like UNITAID, UNAIDS, WHO, and bilateral donors have contributed to this achievement.

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While the rich world has a responsibility to provide funds and technical assistance to fight diseases to save lives in low income countries, the developing countries must also have a similar responsibility toward their citizens.  China, India, Brazil, South Africa, and Russia have already taken steps to fund their own programs.  These countries have received major funding from the Global Fund between 2005 to 2010. Many low income countries in Asia, Africa, Latin America, and Middle East are also taking steps to contribute from own resources.  In 2001, African countries made a commitment to cover 15 percent of health care costs from own resources. As of now, only six countries: Botswana, Burkina Faso, Malawi, Niger, Rwanda and Zambia have met this commitment.

Innovative initiatives by UNITAID and Gates Foundation have contributed to bringing new drugs and diagnostics to low income countries.  UNITAID focusses on low and middle income countries. UNITAID looks at market entry barriers to new products and introduces market-based interventions to reduce prices as well as pre-qualify drugs and diagnostics so that developing world has quality assured products at affordable prices. It also facilitates generic drug production at the country level so that low income countries can afford the products at much lower prices.   UNITAID remains a small investor but more can be done if more funds are made available so that it can facilitate more pharmaceutical and diagnostic companies to provide much needed products at lower prices.  UNITAID investment will allow Global Fund to use existing resources to reach many more people, thus increasing value for money of its investment.

Recently, a Japan-based fund, The Global Health Innovative Technology Fund (GHIT Fund), has invested $5.7 million in six global partnerships to develop new Malaria vaccines, anti-Malarial compound, and novel vaccine candidate against tuberculosis.  A number of public and private sector companies are part of this initiative.  Gates Foundation is investing millions of dollars for vaccine development.  JP Morgan Chase and the Bill & Melinda Gates Foundation have established a new investment fund for late-stage vaccines and technologies to address global healthcare needs.  UNITAID board decided to invest in four private companies to bring new diagnostics in HIV testing area.

Any investment in Global Fund must be conditional on two actions: (i) prepare the low and middle income countries to assume more financial responsibilities for their programs, and (ii) support and facilitate new, quality assured products to enter the developing countries market.

We should fund the Global Fund, no doubt about it.  But we should ask the right questions now and initiate a change that would make a difference in development assistance.  We should ask what actions can be taken so that existing resources can reach many more people and what arrangements can sustain our past investments. Our resources are finite but global collaboration can be limitless.

Rahman is an international health specialist.